Running into former patients

[Volley88]

I have worked in a Medsurg unit for over a year in a big city (Bay Area, CA). I would never expect to run into a former patient that has been discharged recently.

During my weekend off, I was at a bar with a few of my friends. Someone tapped on my shoulder and it was my patient! I did not know how to approach it. My patient introduced me to his friends as his nurse from a week ago. He enjoyed my care and happy with the discharge process. We shared a drink or two and parted ways after an hour.

Was my interaction appropriate? How else should I have handled it? What should be my mannerisms for the next time I run into a former patient?

[Volley88]

Thank you for your input everyone! I am NOT talking about a frequent flyer, hx of homeless, or hx ETOH/drug abuse. I am talking about a patient who is awake and alert, cooperative with care, and a very acute diagnosis not relating ETOH/drug.

I appreciate all your opinions. In nursing school and in the floor, it was never discussed how nurses should react when they see their former patients. After speaking to my peers, no one really talked about how to handle the situation of running into a patient outside the hospital. It seemed we would have to figure it out ourselves. I am not sure if I violated any hospital rules or policies. Although, I believe it falls under our own ethics.

[Alex_RN, BSN]

Thank you for your post. The different perspectives have been eye opening.

[audreysmagic, RN]

I work in a free standing psych facility in a small suburb of a major city. We get patients from all over still we nurses that live locally are pretty well known to the local psych population who happen to be homeless. I never initiate contact when I see them but don't ignore them if they say Hi. They usually will say something like they are taking their meds and we nod and smile and away we go.

Hppy

As someone who also works in a freestanding psych facility, in a major city, I have the same policy. I don't initiate contact unless they do, but if they approach me, I'll make polite conversation. (If it's one of the Difficult Patients and I see them before they see me, I often find someplace else to be quickly, but on public transit, that's not always an option). I try to keep the interaction low-key and professional. I've also had people see my tote bag that has the hospital's logo and tell me they got clean there (my facility also does drug/alcohol rehab, though that's not my floor). I wish them well and congratulate them on their sobriety or offer what polite encouragement I can if they say they've relapsed.

In the "I should have definitely waited for the next bus" files, I was getting off work one night and a visitor was leaving the facility at the same time. He looked familiar but I said nothing until he said hi to me and was then, "You know the Smith brothers (not the real name), right? I'm the older one! I was just visiting my brother today." I wished him and his brother well as the bus arrived and found my seat. And he latched on to me, sat down beside me, and continued to want to chat...but as it was about books, I couldn't even really bow out professionally. :) It had just become one of those awkward bus moments. Fortunately, my stop was only about 10 minutes away...

[Lane Therrell FNP, MSN, RN, NP]

If it's somehow inappropriate or wrong to interact with others outside of the workplace, then something's wrong. After all, nurses are supposed to be vehicles of human caring, right? Having said that, I definitely believe that "former patient" is a different situation from "current patient." I used to run into my current patients all the time in the small rural town where I was a primary care provider at a clinic. It was always a challenge to stay friendly, courteous, and professional while also helping the patients understand that trying to hit me up for free healthcare advice while in line at the drug store was not okay. I developed a go-to "response protocol" for myself in case I ran into a patient in public: I would always acknowledge their eye contact and greeting, but I would wait for them to initiate any conversation. If they initiated conversation, I would engage at a superficial level. If the patient brought up specific symptoms or health or professional issues, I would encourage them to make an appointment to come visit with me at the clinic so we could have privacy and they could get the full benefit of my attention. If they persisted, I would say, "I would need to have your chart in front of me to give you the correct information about that" and that would usually do the trick. I was prepared to be super-blunt with an "It's not appropriate to talk about that here" response, but I never had to go there. Meanwhile, I made sure I was always open to courteous, brief, professional, small talk to keep from putting them off or damaging rapport. After all, I knew I would be seeing them again soon at the clinic for their next encounter. Things may be different in a small community as opposed to a big city, but people are people wherever you go.

[WishfulThinkingRN]

I work in a small-town clinic and run into both current and former patients on a regular basis, at the store, at restaurants, gas pumps etc. I never make initial contact, but most of them will say hi or stop me to chat. My issue is that my personality in the office is very, very different from the one I have off the job. I act very outgoing and energetic when I'm interacting with patients in a professional capacity, but the second I clock out, I revert back to being my introverted, need-my-personal-space self. So when patients stop to talk to me, I'm like a totally different person to them. I'm still nice and polite, I'm just not bubbly. A lot of them even ask if I'm feeling well. I always say no, I think I'm coming down with something, and then they can't wait to leave me alone

[Orion81RN]

"Oh, hi, there! Glad to see you're doing well. Enjoy your evening!"

EXACTLY! "Enjoy your evening," and starting to turn or walk or back away is all the hint one needs.

[Ruby Vee, BSN]

If it's somehow inappropriate or wrong to interact with others outside of the workplace, then something's wrong. After all, nurses are supposed to be vehicles of human caring, right? go.

I would take issue with your premise that nurses are "supposed to be human vehicles of caring". Nurses are people. We're not caring embodied. We're people.

[RNGummy40]

If I saw a patient that I provided care to, if I did not have concerns I would only acknowledge them if they initiated contact.

I definitely would not have a drink with any of my patients. You are definitely taking a risk, consuming a dis-inhibitor with a former patient. I have heard of and see about a handful of bad out comes when coworkers have had to change their contact information, block patients from facebook, or file a police report. It is more difficult when I am with friends or family and I have to ask them to trust me because I recognize a high risk patient and I can't tell them why. I wish my experiences were just isolated to Psychiatric Nursing. One coworker was stalked by another patient after a med-surg length of stay, thankfully they were able to arrest the patient before the situation escalated.

[hadden8176]

I used to work Psych and would run into patients at Walmart lol. I would ignore them and then leave. ITs kinda a pain in the butt if you live in a small town.. your bound to run into a patient sometime